Guest: Dr. Sylvia MorrisPresenter: Neal HowardGuest Bio: Sylvia E. Morris received her M.D. from Georgetown University School of Medicine and Master’s in Public Health from Johns Hopkins Bloomberg School of Public Health. A former assistant professor at Emory University School of Medicine, she is currently an independent healthcare consultant and a community health advocate.
She is board certified by the American Board of Internal Medicine and the American Board of Holistic Medicine. Morris cares for hospitalized patients with a variety of conditions. Some of her areas of expertise include: hospital medicine, preventive medicine, holistic medicine, and internal medicine – including chronic diseases such as heart disease, high blood pressure, diabetes and obesity.

Segment overview: Dr. Silvia Morris, MD, talks about the benefits of a hospitalist to patients and primary care physicians.

Transcription

Health Professional Radio – Hospitalists Benefits

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, thank you so much for joining us today. Our guest in studio is Dr. Sylvia Morris, she received her MD from Georgetown University School of Medicine and she’s currently an Independent Healthcare Consultant and a Community Health Advocate. She’s in studio today with us to talk about the benefits of Hospitalists to patients and Primary Care Physicians as well. How are you doing this afternoon Dr. Morris?

Dr. Sylvia Morris I’m doing wonderful, thanks for having me.

N: Thank you so much. You’ve been a Hospitalist for how long? You didn’t start out as a Hospitalist, am I correct?

M: No, actually coming out of Residency. I finished Residency in 2001 and my first job was a Hospitalist at a big HMO in the Pacific Northwest.

N: So did you find that this was something that you wanted to continue to pursue immediately or this is something that had to grow on you?

M: Well, we all kind of come to work a little bit differently and certainly in my training in Internal Medicine, I spent a lot of time in the hospital. So, part of it was sort of a comfort level with being used to acutely ill patients and their management. So it was sort of a natural progression for me to decide to be an in-patient physician or Hospitalist, because some of us certainly like the out-patient setting better. So they gravitate more toward clinic or out-patient Medicine and there are those of us who like being in the hospital.

N: It doesn’t matter who I talk to when it comes to giving care, the focus is always on giving the absolute best care as a physician, as a health care provider whether you’re an EMT first responder, it doesn’t matter if you’re giving care. Your focus is always on giving the absolute best care that you can. When you became a Hospitalist, did you find that the benefits, as far as they are related to the care of the patient, did they show themselves more readily as benefits as a Hospitalist from your point of view?

M: Well certainly as a Hospitalist, because you were in the building with the patient 12 hours a day and there’s someone there overnight, then that lends in itself to being able to do what’s necessary irrespective of time. When there is a push-pull between those being in the clinic setting and then also taking care of hospitalized patients, it kind of going back and forth, for some Physicians that is less than ideal because they’re busy on both spots. But for Hospitalists, it really becomes easier to know what’s going on with the patient to establish relationships within the hospital as far as other Consultants and the other services that you’d need to use for the betterment of your patients.

N: Talking about some of the errors that can possibly occur in the day to day operations of any healthcare facility, as a Hospitalist, how involved are you or are other Hospitalists involved when there is a question of judgement on the part of a healthcare provider? Is this something that you stay hands off of or are you involved in that aspect as well once that becomes evident, once an error has become evident?

M: Well I think there’s sort of two prongs to your question. So I guess the first question that I’m hearing from you is well if there’s an error how is the medical error handled in the hospital setting? And then the second question is sort of the person, perhaps was responsible or maybe associated with the error. So I’m gonna take the first question first. Certainly, I like to say the hospitals are dangerous places and we say that quote sort of tongue-in-cheek, but certainly there are lots of things that can occur in hospitals and they’re full of sick people that they don’t always respond just like it said they should, they ought to, as far as the Pathology book or the Pharmacology book. So that in and of itself creates sort of an environment where, unfortunately, things happen. And if in fact there is an error, the biggest thing is to have the conversation with the patient, with the staff member, with whomever so there is an acknowledgement of the error and then obviously whatever needs to be done to rectify it.

N: Many times when we talk about being an employee of the hospital, your focus is on the protection of the hospital as an entity even though you care about the patient. As a Hospitalist, can your loyalties float more toward the patient as opposed to the institution?

M: No, I wouldn’t say that the loyalty is more toward the institution. At the end of the day we’re physicians and what we are charged to do is to do what is the best interest for the patient. So you think about the patient as an individual and what I always would say to myself was “What would I want done to the family member that I happened to like?” You always want your best done for if it’s your favorite grandma, your uncle, whomever it happens to be and that’s what you do. Now am I naïve enough to think that because of the environment in which we practice medicine, there are certainly economic constraints, the resource constraints, all of those things. But we are charged first and foremost with taking care of the patients to the best of our ability given what we have and we are always patient advocates first. Because Medicine, even though the talk about it being a business, the business of healthcare – at the end of the day it is a relationship between the physician and patient or nurse and patient.

N: So at the end of the day, I can see that it’s always the health of the patient comes first. But during that day, what are some of the benefits that the Hospitalist can afford to the physicians to whom they are so involved with intimately in coordinating the care of the patients? How does their experience benefit as a health care provider from the Hospitalist?

M: Well certainly, we are always dependent upon people coming to the hospital and their Primary Care Physicians entrusting their care of their patients to Hospitalists. So certainly the Primary Care Physician doesn’t have to then come to the hospital to take care of the patient, doesn’t have to worry about calling the consults, to discharge planning, the history of physicals, all of the things that are really integral to someone being hospitalized.

N: If you’re a specialist in someone, one thing that you know all the ins and outs, you are a specialist in what needs to take place with your particular patient, either upon coming into the hospital and upon leaving. How are Hospitalists received by other Specialties, not just healthcare providers in general as they coordinate care, but the Specialties themselves?

M: Well Hospitalists work closely with, if you’re talking about the Cardiologist or the Pulmonologist or the Nephrologist or the Cardiothoracic surgeon because Hospitalists take care of the overwhelming percentage of in-patients whom we’re talking about adults in a hospital. So we’re gonna set aside pregnant women and newborns and talk about just adult medicine patients. So given that, there is a lot of collegiality and certainly give and take coordination between Hospital Medicine and the other Specialties because we do a lot of the work and they need us and we certainly need them. And when you talk about Hospitalists in terms of quality of care, certainly length of stay is shorter with Hospital Medicine patients compared to patients who are on the non-Hospitalist service. So there are some impacts of quality as well and when you talk about the organization, certainly every organization is concerned about both patient care and patient satisfaction, but then also length of stay.

N: And where can our listeners get more information about Hospitalists and the benefits that they can provide to both the patient and the Physician?

M: They definitely should take a look at the Society for Hospital Medicine and there would be lots of answers to their questions there.

N: Thank you so much. You’ve been listening to Health Professional Radio, I’m your host Neal Howard. We’ve been in studio this afternoon talking with Dr. Sylvia Morris, a former Assistant Professor at Emory University School of Medicine, currently an independent Health Care Consultant and Community Health Advocate. Board certified by the American Board of Internal Medicine and The American Board of Holistic Medicine. Dr. Morris cares for hospitalized patients with a variety of conditions, some of her areas of expertise include Hospital Medicine, Preventive Medicine, Holistic Medicine and Internal Medicine. And she’s been in here talking with us about the benefits that Hospitalists can afford to patients and Physicians alike. It’s been great having you here with us today Doctor.

M: Thank you very much.

N: Thank you. Transcripts and audio of this program are available at hpr.fm also at healthprofessionalradio.com.au and you can subscribe through our podcast on iTunes.

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